The role of hygienic, demographic, social determinants in the formation of occupational morbidity in Ukraine depending on the employment of the population, demand and supply on the labor market in pre-war and wartime

Abstract

The identification, registration, and analysis of occupational diseases remains a pressing issue, especially when the regulatory framework governing this process has changed significantly, and changes in the composition of the population, its employment, and organizational difficulties in conducting diagnostics and recording occupational diseases during military operations against the backdrop of widespread migration of the population within the country and beyond its borders. Therefore, the identification, registration, and analysis of regional characteristics in the formation of occupational disease indicators in Ukraine remains a pressing issue, and its relevance will increase during the post-war reconstruction phase, when a predicted shortage of working-age population will arise. The aim of the scientific research is to identify the characteristics of the formation of occupational disease indicators in dynamics for the period 2011–2024 (for the years before the start of hostilities on the territory of Ukraine and during various stages of the armed aggression), as well as changes in regional conditions and factors influencing their formation. Materials and methods. Determination of the number of occupational diseases based on the principle of complete statistical sampling of primary data for all cases first detected and registered in Ukraine in the period 2011–2024, taking into account military, hygienic, and social aspects. Statistical data were obtained from the State Labor Service of Ukraine and the Pension Fund of Ukraine. The materials were processed using generally accepted methods of sanitary statistics and descriptive epidemiological analysis. The following methods were used during the study: bibliosemantic, medical-statistical, and structural-logical analysis. Results. It was found that the number of occupational diseases detected in the period from 2011 to 2024 changed from 2011 to 2013, when the war in Ukraine began, from 2014 to 2021 – a period of adaptation of workers to the changed conditions of life in society, and the years 2022–2024 – a period of martial law. The registration of occupational diseases decreased by 3.3 times compared to the pre-war period due to underreporting associated with the closure of enterprises, a decrease in the working population in manufacturing, widespread migration of the population, and the destruction of the structure of medical care for workers. In 2024, not a single case of occupational disease was registered in 12 regions of Ukraine. A significant share of the reduction in employment fell on industrially developed regions, in particular, there was a significant reduction in employment in the Kharkiv, Dnipropetrovsk, Odesa, Mykolaiv, Kyiv regions and in the city of Kyiv. The share of the simplest professions decreased the most. In the professional structure of registered unemployed persons, there is a decrease in the share of machine and equipment maintenance workers, and a shortage of workers in traditionally male professions is becoming noticeable. Conclusions. In the dynamics of observation for 2011–2024, three periods can be distinguished: 2011–2013 as pre-war; 2014–2021 as the period of the beginning of the war, the occupation of Crimea, Donetsk and Luhansk regions; 2022–2024 as the period of full-scale Russian invasion of Ukraine. During all these periods, there was a transformation of socio-economic and demographic determinants, changes in migration processes, the labor market, and medical care for the working population. These phenomena were reflected in occupational disease indicators. Thus, in 2024, despite a significant decrease in the total number of occupational disease cases in Ukraine, relatively high and very high indicators were observed in the Dnipropetrovsk, Lviv, Donetsk, and Zaporizhzhia regions. In 12 regions of Ukraine, not a single case of occupational disease was registered. Overall, there was a decline in the effectiveness of the occupational health service in terms of prevention, detection, recording, and registration of occupational diseases. Against the backdrop of domestic and European trends and taking into account the negative impact of the war on working conditions, the quality of life of workers, and their medical care, programs to preserve the country’s labor potential and promote the use of new forms of employment will be necessary in the post-war period. In the post-war period, recovery programs should promote the use of new forms of employment, which, in particular, requires the development of domestic labor legislation in terms of further promoting flexible forms of employment and preventing the risks associated with their use, efforts to create decent working conditions, medical and social technologies for maintaining and improving the health of workers.